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Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 68-74

Gliomas: History of diagnosis and classification: Part 2

1 Department of Neurosurgery, Apollo Hospitals, Hyderabad, Telangana, India
2 Department of Pathology, Apollo Hospitals, Hyderabad, Telangana, India

Correspondence Address:
Dr. Amitava Ray
Third Floor, Nirvanaz, 8-2-293/82/A/240, Road 36, Jubilee Hills, Hyderabad - 500 033, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJNO.IJNO_200_20

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In the first article of this series, we traced the history of glioma classification from the middle of the 19th century to the start of the current revolution in classification driven by molecular markers. Although molecular markers were used sporadically in the past to enumerate specific cancer dysregulated pathways, it was never an integral part of the classification. This article tries to summarize the changes that have taken place since the recommendations following the Haarlem meeting in 2014. The objective of this article is to highlight how molecular classification impacts diagnosis, prognostication and management of brain tumors, and the integration with traditional histopathology. This review article is an exhaustive review of the literature summarizes the gradual evolution in glioma classification starting with 1p19q as described in the late 20th century, the value of methyl-guanine-DNA methyltransferase promoter methylation leading up to the World Health Organization 2016 classification. It touches upon the current trends of transcriptomic and epigenetic classifications, highlighting the advantages and pitfalls of each testing method. At this time of rapid advancement, this article helps us understand current grading and classification, offering insights into how this may evolve in the future. Understanding the concepts of integrated molecular and histopathological grading holds the key to future research in the field. It will also be invaluable in being able to choose the best therapeutic option for patients, for whom a plethora of diverse management options may be available.

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